QUESTIONS & ANSWERS

Can acupuncture be more effective for infertility treatment than clomifene (Clomid, Omifin)?

A new study finds acupuncture more effective than clomifene for the treatment of infertility. Clomifene, trademarked as Clomid and Omifin, is the most widely prescribed fertility drug on the market. It is an estrogen receptor modulator that induces ovulation. In this study, 65 women with infertility due to dysfunction of ovulation were divided into two randomly chosen groups. Group 1 received electroacupuncture and group 2 received 50mg per day of clomifene citrate tablets. After 6 months of treatment, the acupuncture group had a cure rate of 76.3% and the clomifene group had a 48.1% cure rate.

Another recent study demonstrated that acupuncture increases the frequency of ovulation for women with polycystic ovarian disease (PCOS). Published in the prestigious American Journal of Physiology - Endocrinology and Metabolism, the research took over a year of investigation. Researchers measured significant changes in sex steroids, hormones, inhibin B and serum cortisol. Acupuncture normalized levels of these secretions and simultaneously increased ovulation frequency.

Fertility treatments are one thing but live birth rates are the ultimate goal. Just this year, new research demonstrated that acupuncture administered to women receiving IVF, in vitro fertilization, increases live birth rates. The discovery was that women had a higher rate of pregnancy and live births if acupuncture was administered on the day of the embryo transfer of donor eggs. A special acupuncture protocol was developed and carefully documented.

Another recent investigation found that electroacupuncture improves pregnancy rates and live birth rates for women receiving IVF. Researchers isolated specific and measurable responses to electroacupuncture. They found that electroacupuncture increases blood levels of HLA-G (human leukocyte antigen) and the level of HLA-G secreted in embryos for the patients in the process of IVF-ET. Presence of the HLA-G protein is predictive of higher pregnancy and live birth rates. The team noted that the pregnancy outcome and the pregnancy rate are improved for all women when electroacupuncture is applied.

Can acupuncture be more effective for infertility treatment than clomifene (Clomid, Omifin)?

Can the length of pregnancy vary by up to five weeks?

Yes. The length of a pregnancy naturally varies between different women by as much as five weeks, scientists have discovered for the first time.
Although it has always been known that human pregnancies usually last between 37 and 42 weeks, the variation has previously been attributed to imperfect methods of estimating due dates. A woman's due date is calculated as 280 days after the onset of her last menstruation and is only ever considered a best guess. Only four per cent of women deliver on their due date and only 70 per cent within 10 days of it.

However researchers from the National Institute of Environmental Health Sciences (NIEHS) were able to pinpoint the moment women became pregnant by taking daily urine samples - enabling them to isolate the role that natural variation plays in pregnancy length.

In a group of 125 women, they found the average time from ovulation to birth was 268 days - 38 weeks and two days - and that the length of pregnancies varied by as much as 37 days, according to the research, published today in the journal Human Reproduction.

The length of a pregnancy could be affected by a number of factors. Older women tended to deliver later, while women who had themselves been heavier at birth also had longer pregnancies. The Royal College of Midwives (RCM) said the research reaffirmed professionals' experience that every woman is different and urged practitioners to be cautious intervening too early in pregnancy, but said that due dates were still useful. It should be explained to the woman that the due date is always an estimate and as this research shows, this can vary widely.

Can IVF infertility treatment cause ovarian cancer?

Although a huge money making part of the infertility industry, IVF has many downsides including the fact it is enormously expensive. A single IVF cycle treatment can cost over $12,000 and it can take many IVF treatments to achieve a pregnancy.
What's more, the success rate after spending all this money is only about 13 to 43 percent, depending on the age of the would-be mother, with older moms having less chance of a successful pregnancy. On top of these drawbacks, the drugs given for ovarian stimulation have a host of side effects, according to the National Institutes of Health (NIH), including bloating, abdominal pain, mood swings and headaches.

Now there's evidence of an even more potentially horrendous side effect to this baby making technology — ovarian cancer. Researchers from the Netherlands have discovered that women whose ovaries are stimulated into producing extra eggs for IVF double their risk of having ovarian malignancies later in life, compared to women who never undergo IVF. The study was just published in Europe's leading reproductive medicine journal Human Reproduction.

The specific type of ovarian growths found that are most likely spurred by IVF are known as borderline ovarian tumors. While far less deadly than invasive ovarian malignancies, they are nothing that can be ignored. The researchers found that of the 25,152 women with fertility problems included in their study, 77 developed ovarian cancers. Surprisingly, of the 61 women who had ovarian malignancies in the group that had been treated with IVF, 31 had borderline ovarian cancer and 30 had invasive ovarian cancer.

Can DHEA supplement help in infertility?

According to the American Pregnancy Association, six million women a year deal with infertility. Now, Tel Aviv University study is giving new hope to women who want to conceive - in the form of a pill they can find on their drugstore shelves right now. Prof. Adrian Shulman of Tel Aviv University's Sackler Faculty of Medicine and the Meir Medical Center has found a statistical connection between the over-the-counter vitamin supplement DHEA, used to counter the effects of aging, and successful pregnancy rates in women undergoing treatment for infertility. In the first controlled study on the effects of the supplement, Prof. Shulman found that women being treated for infertility also received supplements of DHEA were three times more likely to conceive than women being treated without the additional drug. The result were recently published in AYALA, the journal of the Israeli Fertility Association. Prof Shulman and his fellow researchers conducted a study in which a control group of women received treatment for poor ovulation, and another group received the same treatment with addition of the DHEA supplement. The latter group to 75mg of the supplement daily for 40 days before starting fertility treatments, and continued for up to five months. Not only were women who combined infertility treatment with DHEA more likely to conceive, the researchers discovered, they were also more likely to experience a healthy pregnancy and delivery. In the DHEA group, there was a 23% live birth rate as opposed to a 4% rate in the control group. More than that, of the pregnancies in the DHEA group, all but one ended in healthy deliveries.

Prof. Shulman believes that women who are finding little success with their current fertility treatments could look to DHEA to improve their chances of conceiving. Women interested in using DHEA to conceive, however, should consult their doctors first, suggests Prof. Shulman, a gynecologist and director of the IVF Unit of the Obstetric and Gynecology Department at Meir Medical Center. Prof. Shulman hopes that further research will unlock the secrets of why the supplement aids in successful conception in women with an otherwise poor response to fertility treatments.

Stress and Infertility?

Women with elevated stress levels might be less likely to get pregnant, according to a study published recently in the journal Fertility and Sterility. For the study, the researchers followed 274 British women ages
18 to 40 years old who were already participating in the Oxford Conception Study, which assessed whether information from infertility-monitoring devices increased the likelihood of conception. The women were tracked for six menstrual cycles or until they conceived, depending on which came first. Saliva samples were collected on the sixth day of each cycle and analyzed for alpha amylase and cortisol, two substances that measure the body's reaction to physical or mental stress. The research accounted for several outside factors that can influence conception, including alcohol intake, frequency of intercourse and the couple's age. They determined that the couples had an average 30% chance of conceiving each cycel.
However, women with the highest concentrations of alpha amylase in the first cycle were 12% less likely to conceive than women with the lowest levels, the study found. Cortisol levels were not linked to a woman's chance of conceiving, according to lead author Germaine Buck Louis of the National Institute of Child Health and Human Development. Buck Louis noted that alpha amylase mimics the "fight-or-flight" response to immediate stressors, such as noise or temperature.

Why haven't infertile couples been told these facts?

Millions of people have celiac disease, but most don't know they have it, in part because symptoms can be so varied. It is an often overlooked digestive disorder that causes damage to the small intestine when gluten, a protein found in wheat, barley and rye, is eaten. Infertility seems to be more common in women with untreated celiac disease. Other gynecological and obstetrical problems may also be more common, including miscarriages and pre-term births. For men, problems can include abnormal sperm - such as lower sperm numbers, altered shape, and reduced function. Men with untreated celiac disease may also have lower testosterone levels. The good news is that with proper treatment with a gluten-free diet and correction of nutritional deficiencies, the prognosis for future pregnancies is much improved.

Any recent news about the assisted reproductive technology (ART) treatments? Are they really ineffective?

According a new study at the University of Aberdeen, common fertility treatments given to thousands of couples do nothing to boost their chances of getting pregnant. Giving couples a popular fertility drug or common form of insemination are no more effective than encouraging them to "keep trying", researchers said. Both treatments are officially recommended as one of the first courses of action for couples having trouble conceiving.

They are designed to improve fertility rates either by stimulating egg production in the ovaries or by injecting sperm directly into the womb.
But the study suggests that both have little or no effect on conception rates. Researchers looked at 580 women with unexplained fertility problems who were trying to get pregnant over two years. They found that 17% of those who did not have any kind of medical intervention conceived over that time. However, only 14% of the couples taking Clomifene citrate got pregnant. And that figure was only slightly higher, 23%, for those who had unstimulated IUI. The researchers who led the study said that both treatments would have to have a much greater impact on pregnant rates to prove that they were any more effective than having no treatment at all.

Prof. Siladitya Bhattacharya, who led the research, said: "These interventions, which have been in use for many years, are unlikely to be more effective than no treatment." Fertility experts from Guy's and St.

Thomas' NHS Foundation Trust said that as a direct result of the lack of evidence, many couples with unexplained infertility endure (and even
request) expensive, potentially hazardous, and often unnecessary treatments.

Any recent news about the assisted reproductive technology (ART) treatments? Are they really ineffective?

Would you suggest to have Caesarean?

According to British Medical Journal ( 2007; 335:1025-9), women who have a Caesarean section delivery double their chances of dying or suffering a serious illness, a new study has discovered. They are also five times more likely to suffer infection afterwards compared with women who have a natural birth. An earlier study also found the procedure puts the baby at greater risk, too. A baby born by Caesarean section is three times more likely to die soon afterwards compared with the one born naturally. The dangers of Caesarean delivery came to light when researchers from Oxford University tracked the progress of 97,095 births from health facilities throughout Latin America. The operation was only less dangerous for the mother when the baby was in breech position, and it was considered a necessary intervention. But many of the procedures that went wrong for the mother or baby were elective; in other words, the mother decided to have the operation even though there was no medical reason to do so. The World Health Organization reckons that the rate of Caesarean sections should never be higher than 10 per cent of all births; that should be sufficient to cover any complications, they estimate. In fact, around 30 per cent of all births in the USA – and the figure is only slightly lower for the UK – are by Caesarean section. In Latin America, the rate is the highest in the world at 33 per cent.

How my menstrual cycle will affect my fertility?

According to the journal Epidemiology (January, 2006), a new study suggests that certain characteristics of a woman's menstrual cycle may confer increased fertility, while others may lead to a greater risk of miscarriage.

To investigate whether the length of a woman's cycle and her menstrual bleed are related to fertility and pregnancy outcome, researchers followed 470 women for 1 year or the end of a pregnancy.

All of the women kept diaries on their menstrual cycles and collected urine samples for at least 2 days during each cycle. 38% percent of the women became pregnant during the course of the study, with a total of 207 pregnancies. 30% of the pregnancies ended in miscarriage, according to a report in the journal Epidemiology.

Pregnancy was most likely to occur after cycles lasting 30 to 31 days, the investigators found, and 40% less likely after shorter cycles.

Miscarriage was three times more common after cycles that were either shorter than or longer than 30 to 31 days. Conception occurred most frequently after menstrual bleeds lasting 5 days, while spontaneous abortion was 60 percent less likely after periods lasting longer.

What is spontaneous ovulation? Can I ovulate more than once during my cycle?

In 1956, Dr. Jonas noticed that many women conceive outside their presumed "hormonal regular ovulation". He dedicated his entire life to this research. Only recently, in 2003, other independent studies confirmed what Dr. Jonas concluded 50 years ago - there is no 'safe' time to avoid pregnancy. Doctors have believed that about a dozen follicles, or egg sacs, grow at one time during a woman's menstrual cycle. From this group, only one follicle actually bursts and releases an egg, while the others shrivel and die. But, in a finding that left even researchers flabbergasted, scientists have found this pattern of follicular development actually occurs two to three separate times during a woman's menstrual cycle. What's more, 60 per cent of women have the biological potential to ovulate more than once during a cycle. The old idea of one time per cycle is wrong. The results help explain for the first time why some women get pregnant while on birth control pills, and why the window for safe sex may not exist at all for many women -- because there may always be an egg sac waiting to release an egg. The discovery could lead to more effective contraceptives and could boost success rates for women undergoing expensive and invasive high-tech infertility treatments. For decades, the medical dogma held that a woman's ovaries behaved one very certain, very specific, very predictable way. Normally, women have a 28-day menstrual cycle, and the belief was that most women ovulate once, around day 14. This is however only a myth. The cycle begins on the first day of bleeding. By about day five, the theory held, about 15 to 20 egg sacs start to mature and then, by day 14, the most mature follicle ruptures, releasing an egg. But, those assumptions were largely based on blood samples and menstrual diaries. The researchers finally looked at the ovaries to find out what they were doing during the cycles. Women with normal menstrual cycles volunteered to undergo high-resolution ultrasound every day for a month so researchers could follow the fate of every individual follicle. Although the women all released only one egg during the study cycle, they had the biological machinery to ovulate more than once. Another study suggests women can still get pregnant during their hormone-free interval, because there's enough space in the pill-free period that allows the development of a new wave of follicles. The research may also explain why some women undergoing in vitro fertilization and other fertility treatments don't respond to ovary-stimulating drugs. Doctors are probably giving at least some of the women drugs at the wrong time.

What is spontaneous ovulation? Can I ovulate more than once during my cycle?

NO - Relying on BBT charts to time your intercourse, and then still failing to conceive, can in itself be responsible for an undue amount of stress. When we tell our patients to throw away their basal thermometers, we take the first big step in reducing some of the pressure involved in their infertility treatment. BBT is a much misunderstood test. Many couples think that they can use their BBT charts to determine the best days on which to have intercourse in order to conceive. They don't realize that a BBT chart is of historical value only. It can indicate,after the fact, that you did ovulate. Over a period of months it can show you whether your ovulation is more or less regular. But what it CANNOT do is predict when ovulation is about to occur. If your goal is to have intercourse, or precisely timed fertility testing, that coincides with ovulation, a basal body temperature chart is NOT an accurate indication of when it will occur.

Do you recommend vaginal douching?

NO - definitely NOT! Vaginal douching will NOT influence the sex of your baby. On the other hand, it can be harmful to your vaginal health - leading to a possible yeast infection or bacterial vaginosis (BV). This condition can definitely increase the rate of preterm labour and probably also increases the rate of miscarriage, pelvic inflammatory disease, and ectopic pregnancy, and delays conception.

We got married and we are planning to have a family. Since there is a genetic disease running in my husband's family, doctors didn't recommend us to have a male since it is passed on only in males. Can we have only two baby girls?

YES - There is a category that is specially dedicated to this kind of problem to prevent tragedies and genetic diseases occurring. Please apply for the Healthy Child category. If you are planning to have three children, please apply again after you conceive your first child so that you will be able to plan the gender of your third child

We got married and we are planning to have a family. Since there is a genetic disease running in my husband's family, doctors didn't recommend us to have a male since it is passed on only in males. Can we have only two baby girls?

What if my highly fertile days fall into my menstruation period. Can I still get pregnant?

YES - There have been many cases when the woman is fertile during her menstruation period. Women of one tribe in Africa for some religious reasons are having intercourse only during their menstruation and they still have children. If our report shows that your highly fertile day falls into menstruation it means you will be extremely fertile and it should be used as the most favourable conception time. Conception during menstruation has been explained by a combination of short cycles, long periods and the life of the sperm. In a short menstrual cycle ovulation may come very soon after the period. Given the presence of protective fertile mucous during the last days of menstrual bleeding, the sperm may live for several days, being unaffected by the flow of blood, and therefore reach the ovum, or egg, at ovulation. However many women conceive during their periods when they have no history of short cycles, and also are not experiencing any precipitating factors for an early ovulation such as stress, travel, medication, altered diet, ill health etc. In few such cases, we found that the woman's spontaneous ovulation (red days) had been for some time, coinciding with their period. They had been trying to conceive, but had not had sexual intercourse during their periods for religious reasons. When the couples decided that conception was their first priority, and had intercourse at this time, conception occurred. This situation is difficult to explain even among the medical circles. One possible explanation would be that during the three to five days in which the fertilised egg stays in the fallopian tube, the hormonal situation, possibly changed by the spontaneous ovulation, may affect the state of the endometrium.

What if my highly fertile days fall into my menstruation period. Can I still get pregnant?

I am not having a regular menstruation, can I still use Dr. Jonas method and my individual highly fertile days of conception?

YES - Despite the common medical assumptions, the fact that you are not having a regular menstruation doesn't mean you cannot get pregnant. Dr. Jonas tested his discoveries on over 100,000 women. Some of these women didn't have regular menstruation but they still conceived and became pregnant with a healthy child. Please follow our report and use your individual highly fertile days determined by us. Highly fertile days are your most favourable days to conceive whether your menstruation is regular or irregular. Your chance to become pregnant will be very high during such times.

I am not having a regular menstruation, can I still use Dr. Jonas method and my individual highly fertile days of conception?

I am not ovulating, how can I become pregnant using the Natural Fertility Method?

Ovulation is still in a "dark tunnel" of discoveries. Doctors don't completely understand when ovulation really happens. The research has shown that only 15% of pregnancies have happened during "ovulation time", other pregnancies happened out of this ovulation time. What does it show? The real ovulation is not understood yet and woman's biological rhythm is not as simple as we may think. Of course, we do recommend you to consult the specialist or your doctor. However, don't feel depressed if you are told that you are not ovulating. Please, follow our program for at least 8 months. The results will speak for themselves.

I am not ovulating, how can I become pregnant using the Natural Fertility Method?

My husband has a low sperm count. Can we use Dr. Jonas Method?

YES - Low sperm count is not as huge a problem as the recent research is trying to prove. Let us put it very simply: it only takes one sperm to get the job done! To succeed with the conception, please follow your highly fertile days we provide you with. TCM (Traditional Chinese Medicine) has over 3,000 years of history successfully treating low sperm count or mobility. You may contact your local TCM Association and consult an qualified licensed TCM specialist.

Could toxicity of cosmetic products affect my fertility?

YES. Most definitely.

Phthlates in shampoos and skin care products have been shown in several studies to effect the reproductive system and other organ systems in the body. These substances have been getting a lot of attention in both the media and the scientific community. Not only could they be impacting the fertility of men and women now and future generations, but several hundred animal studies have linked phthlates to prostate and breast cancers, abnormal genitals, early puberty onset and obesity. Studies have linked Bisphenol A to hormone disruption, an increased risk to breast cancer and prostate cancer.

This information is not meant to stress you more than you already are because there is yet again, another thing to worry about, but instead it is meant to empower you so that you can become aware of what you can do to promote good health for yourself and your family. Per several hundred studies this doesn't seem to be an "urban legend" such as your hair dryer could kill you, but it is an issue building up credible evidence by scientists who are not associated with the companies that use the chemicals in their products. Genetics or hereditary components usually account for less than 5 % of cancers including breast and prostate cancers. What if repetitive exposures to these chemicals is tipping the scales towards an unhealthy balance in the body? Let's educate ourselves more about them so we can minimise our exposure whenever possible.